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The following is a summary of “Bleeding Risk Assessment with Thromboelastography in Interventional Pulmonology Procedures,” published in the March 2025 issue of Respiratory Medicine by Abia-Trujillo et al. 

Thromboelastography (TEG) is a point-of-care diagnostic tool that provides a comprehensive assessment of the coagulation cascade. However, its role in predicting bleeding risk in patients undergoing interventional pulmonology (IP) procedures remains insufficiently explored. This retrospective study aimed to evaluate the clinical utility of TEG in assessing bleeding risk among patients undergoing elective IP procedures. The study included patients who underwent TEG testing within 24 hours before their procedure and met standard coagulation criteria ([INR] <2 and platelet count >50,000/mm³). The primary outcome was the incidence of post-procedural bleeding, defined using validated bleeding scales. 

Statistical analyses, including Fisher’s Exact test and binary logistic regression, were performed to assess the association between TEG results and bleeding risk. A total of 76 patients were included in the study, of whom 13 (17.1%) experienced bleeding despite having a normal coagulation panel. Among these patients, 10 (14.9%) had non-hypocoagulant TEG findings (p = 0.082), suggesting no statistically significant association between TEG results and bleeding risk. However, TEG demonstrated high specificity (94%) but low sensitivity (23%) for predicting bleeding. Notably, patients with a hypocoagulant TEG profile exhibited a 5.1-fold increased risk of bleeding ([OR] 5.1, 95% [CI] 0.84–31.29, p = 0.066), indicating a potential association that did not reach statistical significance. Furthermore, 6 patients (8.9%) were classified as hypocoagulable, with 50% experiencing post-procedural bleeding, highlighting TEG’s potential to identify patients at elevated risk. These findings suggest that while TEG alone may not serve as a highly sensitive predictor of bleeding, its high specificity and ability to identify hypocoagulable states warrant further investigation. 

Larger prospective studies are needed to validate these findings and to better define the role of TEG in pre-procedural bleeding risk assessment for IP procedures. Future research should focus on integrating TEG with conventional coagulation tests to refine risk stratification strategies and improve patient safety in interventional pulmonology.

Source: resmedjournal.com/article/S0954-6111(25)00026-5/abstract